Perception of Local COVID-19 Transmission and Use of Preventive Behaviors Among Adults with Recent SARS-CoV-2 Infection — Illinois and Michigan, June 1–July 31, 2022
Authors: Mark É. Czeisler, Rashon I. Lane, Robert C. Orellana, Kristen Lundeen, Kathryn Macomber, Jim Collins, Prerna Varma, Lauren A. Booker, Shantha M.W. Rajaratnam, Mark E. Howard, Charles A. Czeisler, Brendan Flannery, Matthew D. Weaver
Journal: MMWR Morbidity and Mortality Weekly Report (2022)

During the early stages of the COVID-19 pandemic, use of preventive behaviors was associated with perceived risk for contracting SARS-CoV-2 infection (1,2).Over time, perceived risk has declined along with waning COVID-19-related media coverage (3,4).The extent to which communities continue to be aware of local COVID-19 transmission levels and are implementing recommended preventive behaviors is unknown.During June 1-July 31, 2022, health departments in DuPage County, Illinois and metropolitan Detroit, Michigan surveyed a combined total of 4,934 adults who had received a positive test result for SARS-CoV-2 during the preceding 3 weeks.The association between awareness of local COVID-19 transmission and use of preventive behaviors and practices was assessed, both in response to perceived local COVID-19 transmission levels and specifically during the 2 weeks preceding SARS-CoV-2 testing.Both areas had experienced sustained high COVID-19 transmission during the study interval as categorized by CDC COVID-19 transmission levels.*Overall, 702 (14%) respondents perceived local COVID-19 transmission levels as high, 987 (20%) as substantial, 1,902 (39%) as moderate, and 581 (12%) as low; 789 (16%) reported they did not know.Adjusting for geographic area, age, gender identity, and combined race and ethnicity, respondents who perceived local COVID-19 transmission levels as high were more likely to report having made behavioral changes because of the level of COVID-19 transmission in their area, including wearing a mask in public, limiting travel, and avoiding crowded places or events.Continued monitoring of public perceptions of local COVID-19 levels and developing a better understanding of their influence on the use of preventive behaviors can guide COVID-19 communication strategies and policy making during and beyond the pandemic.During June 1-July 31, 2022, adults aged ≥18 years who had received positive SARS-CoV-2 test results within the preceding 3 weeks who were reported to six participating health * CDC transmission levels are categorized as low, moderate, substantial, or high based on new COVID-19 case counts and the percentage of positive COVID-19 tests.CDC transmission levels, used for comparison with public perceptions, are available through the COVID Data Tracker.https://covid.cdc.gov/coviddata-tracker/#county-view?list_select_state=all_states&list_select_county=all_ counties&data-type=Risk&null=Risk (Accessed November 8, 2022).TABLE.(Continued) Perception of local COVID-19 transmission among adults with recent positive SARS-CoV-2 test results -Illinois and Michigan, June 1-July 31, 2022 Abbreviation: NA = not applicable.* Pearson's chi-square tests were used to estimate p-values for differences across groups.A Bonferroni adjustment (10) was applied to account for the number of comparisons.† During June 1-July 31, 2022, a total of 45,626 confirmed COVID-19 cases occurred in the metropolitan area of Detroit, Michigan, and 18,626 confirmed COVID-19 cases in DuPage County, Illinois.§ Respondents answered the question, "How many COVID-19 vaccine doses have you received?"¶ Percentages for this group are derived from among the 4,926 respondents who self-reported health status.Eight of the 4,934 (0.2%) respondents did not complete the question on self-reported health status.